Held every two years, the International AIDS Society conference is a gathering of doctors, researchers, and experts who comes together to discuss and report on the latest developments. This 2015 conference was held in Vancouver, British Columbia, and hosted over 6,500 attendees. While there were numerous presentations and findings presented over the three day event, these are the top highlights:

Guys who get tested frequently love the idea of getting their results right away. While quick tests can take anywhere from 10-30 minutes, which often results in a waiting period filled with anxiety and fear, there is a new one-minute HIV test. This test is the best at detecting HIV in early stages of infection. Interesting fact, this test was developed and manufactured in Vancouver, BC!

Viiv, an HIV drug manufacturer (a partnership between Pfizer and GlaxoSmithKline), reported they are interested in the idea of providing free counselling to people taking their medication. Having HIV can be extremely stressful and finding emotional support can be difficult. The idea would be welcomed by the HIV positive community as another resource available, especially during the early stages of learning they are HIV positive.

Truvada as PrEP is available to in Washington and New York states free of charge. The decision was made to offer the drug for free because it was less expensive to prevent HIV than to treat someone who is HIV positive for his entire life. While the medication is free, the patient still needs to pay for his own lab work, which ranges from $100-300 per month. Canada still lags behind the use of Truvada as PrEP, frustrating many doctors and gay men.

Known as the Berlin Patient, Tim Brown was both HIV positive and was diagnosed with cancer. Tim underwent cancer treatment after his doctor found a donor who was immune to HIV. The procedure resulted in Tim being cured of both cancer and HIV. He is the first person in the world known to be cured of HIV.

Pre-exposure prophylaxis (PrEP) is a controversial subject for some segments of the gay community. There is a false belief that guys who take PrEP will have more sex and unprotected sex, and therefore result in having more STI’s. The studies to date to not support these myths and rumors. However, a small segment of the HIV positive community is having trouble with negative guys taking antiretroviral drugs because they feel it is unfair that they can have sex, without the guilt and worry of contracting HIV. This has lead to some judgement about guys not being responsible. Right or wrong, the fact is, PrEP is safer sex and not a single person who takes Truvada as PrEP on a daily basis has seroconverted.

Treatment as prevention (TasP), is when a person’s viral load has been reduced to such a minimal level that is not detectable, and therefore they cannot transmit HIV. In 2013, there was still some researchers that doubted the studies; however, it has now been proven as an effective method to reducing the spread of HIV because people who are HIV positive undetectable cannot infect others when their viral load count is undetectable.

HIV is a very complicated subject and it is through these types of conferences that information sharing is so important. From how to treat people living with HIV, to treatment as prevention, to keeping people HIV negative, there is much the medical community is still learning and researching. Since the AIDS epidemic of the 1980’s we have come a long way. While there is still much work to be done, there is a sense of optimism that there could be a cure in the near future! We already have prevention!

– See more at: http://www.thehomoculture.com/author/billcoleman/#sthash.izn6gr3H.fdaDSKhW.dpuf

This one tends to continuation on from my last article in Xtra on 15 Dec 2011, but from a new angle.

I recently talked to an MD who works for the government in the field of HIV and s/he said that we need a nuanced message to deal with the new information out there about undetectable viral load reduces the risk of transmitting HIV. S/he feels we need new messaging because s/he see people every day coping with viral load questions. My response was that the CDC does not know the meaning of nuance they only know short messages with an all or nothing message, Later I talked with one of those bureaucrats that is part of developing those all or nothing messages. (S/he does not see patients in real life, and I wonder if s/he only knows about sex from journals and books.) S/he confirmed s/he likes the all or nothing short simple messages. Short and simple seems to be more important than how accurate the message is.

What if you wanted to go skiing and wanted to make sure you would not get injured in an accident on the dangerous highway 99. You could decide to drive only between 2AM and 3AM, when there are fewer cars, you can get the best snow/ice tired there are, you can get the safest car with the most air bags, you could decide to only drive on days when there is no snow or rain. But likely this would not be practical or fun – but safer. Likely you will just drive to the ski hill when you want to ski and tell yourself to be careful. After all you did it for two years and had no problems so just tell yourself to be careful. Well it is a lot like fucking. There are things you can do to make it safer but they may not all be fun or practical.

The Journal Science has declared that the scientific breakthrough of 2011 was a study (HPTN 052), this study found that a person with an undetectable viral load reduces transmission of HIV by 96%. One article said “Having an undetectable viral was as effective as condoms.

That is like going to buy a pair of jeans for $100.00 but finding out they are reduced by 96% so they now cost $4.00. That is a huge difference.

So lets look and what this means for fucking without condoms. If you are getting fucked raw by a HIV poz guy with and undetectable viral load the chance of getting infected goes from 1 in 200 (no HIV treatment) to 1 in 5,000. If you are fucking a poz guy raw with undetectable viral load the chances of getting HIV goes from 1 in 1,538 (no treatment) to 1 in 38,461.

So if you have sex with a poz guy with an undetectable viral load and if you use a condom that reduces it a further 96%. So it is like those $100 pair of jeans go to $4.00, and then are deduced again by 96% and now they cost 16 cents.

We are told that BC government is spending $50,000,000 to get as many positive persons as possible to have an undetectable viral load. They call it “Treatment as Prevention”, but that is just the marketing to the government. It is not preventing HIV transmission but it is reducing the risk of getting HIV by 96%.

The risk of fucking without condoms changes dramatically – yea it is reduced by 96%!. What do us as gay guys do? Do we take more risks? Do we decide that maybe we play more in the sandbox with the poz guys with undetectable viral load because they are not so scary now?

Do negative guys become scarier to play with because 2.5% of them may be poz and not know it and therefore may be 20 -25 time more likely to pass on HIV. For the guys who think they are negative but are newly positive then getting fucked by them changes the risk from 1 in 200 for a (poz guy with detectable viral load) to 1 in 10 for newly poz guy.

You may ask a negative partner if he get tested on a regular basis. If he does it likely is because he is concerned he is maybe positive. So why would you think he is negative if he thinks he may be poz and gets tested regularly to find out.

So if you decide to have sex only with guys who believe they are negative what is the chance of getting HIV? We know 2.5% of those guys who think they are negative are really positive. If we assume that those 2.5% are newly infected and that is why they do not know they are poz then the chance of becoming poz is about 1 in 200 if you choose only guys who think they are negative. An interesting number – it is the same number as getting fucked by a poz guy with detectable viral load.

Where do all these numbers leave us. Well poz guys with undetectable viral load are a lot less likely to infect someone then if they did not have an undetectable viral load. Negative guys who will take risks with you will take risks with others also, – did you think you were special – so he may be poz.

A number of negative guys have told me that often poz guys are just more fun to have sex with than negative guys.

So where does the leave us? Are poz guys (with undetectable viral load) sought after now, and are the “negative” guys shunned as having the potential for infecting others? The science may say there is a good case for this. But after all it is fear and prejudges that made many negative guys shun poz guys in the first place, – it was not science! Our prejudges against poz guys as sex partners will not change easily.

What we do not need is the institutional marginalization of poz guys. Many organizations will tell us we are at higher risk if we have sex with a poz guy. Surveys ask “do you have sex with poz guys?”, they then tell you are at more risk if you do have sex with poz guys, this is not true if the viral load is undetectable. The institutional response should be: “ know your partners viral load” not his HIV status!

Well this is my last regular column in Xtra, I plan on doing a retrospective piece next month outlining what I have learned while writing these pieces and bring up a few points to consider. I may be back with the occasional writing on gay men’s health.